Diabetes Self-Management (DSME) Education Diabetes self-management education and support (DSME/S) is

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  • Diabetes Self-Management (DSME) Education

    Provider Resource Toolkit

    UnitedHealthcare/Medicaid Managed Care Organization Workgroup

    December 2015

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    Empowering Patients, Improving Outcomes Studies demonstrate that patients who participate in diabetes self-management education (DSME) programs are more likely to

    1, 2 :

    • Use primary care and preventive services; • Be more proactive in their care; • Have delayed onset or escalation of diabetes; • Take medications as prescribed; • Have improved clinical outcomes, such as better control of their HBA1c

    levels, blood pressure and LDL cholesterol; and • Have lower health care related costs.

    1 American Association of Diabetes Educators. 2015. Why refer for diabetes education? Retrieved March 15, 2015, from American Association of Diabetes Educators: 2 Diabetes Educators: Supporting You, Empowering Your Patients. AADE PowerPoint. 2015.

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    Contents

    How to Locate a DSME ............................................................................................. 4

    AADE Accreditation and ADA Recognition ............................................................. 5

    Community-Based Programs ..................................................................................... 6

    Joint ADA, AADE and DSME Statement ................................................................. 7

    Prevent Diabetes Stat ................................................................................................. 7

    Provider Tools – Reference Articles .......................................................................8,9

    Referrals and Communication .................................................................................10

    Patient Barriers .........................................................................................................10

    Closing the Loop on Communication and Following a Patient’s Progress .............10

    Doctor/Patient Relationship .....................................................................................11

    Motivational Interviewing .......................................................................................11

    Additional Resources ...............................................................................................12

    Provider Focused Infographic: .............................................................................12

    Patient Focused Infographic: ................................................................................12

    References ................................................................................................................13

    This toolkit was supported by the Pennsylvania Department of Health through the “State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health” (DP13-1305) federal grant from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

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    How to Locate a DSME

    To find a diabetes self-management education (DSME) provider in your area, please go to the Pennsylvania Department of Health Diabetes Webpage at: http://www.doh.pa.gov/diabetesmap

    http://www.doh.pa.gov/diabetesmap

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    AADE Accreditation and ADA Recognition There are two organizations that certify diabetes self-management education (DSME) programs as providing evidenced-based education and support services for diabetes management. These certifying organizations are the American Association of Diabetes Educators (AADE) and the American Diabetes Association (ADA). In order to become certified, a program must meet the 10 National Standards for Diabetes Self-Management Education and Support. The national standards are approved and updated every five years by a task force of experts in diabetes care and management. The task force consists of experts from the areas of public health, underserved populations (including rural primary care and other rural health services), individual practices, large urban specialty practices and urban hospitals. Additional task force members have included individuals with diabetes, diabetes researchers, certified diabetes educators, registered nurses, registered dietitians, physicians, pharmacists and psychologists. Key components of the national standards are to ensure programs have an adequate organizational structure to support the delivery of services and external stakeholder input to ensure program quality and a clear understanding of the target population the program is trying to reach. Specifically, the standards address having the proper staff to deliver the program, curriculum that meets best practices, and individualized care and support plans for each participant. To address lasting care and quality, programs are also responsible for personalized follow-up plans, communicating progress to the referring doctor and engaging in continuous quality improvement to address any service gaps. In depth information on DSME National Standards can be found at: Haas, L., Maryniuk, M., Beck, J., Cox, C. E., Duker, P., Edwards, L., & Youssef, G. (2013). National standards for diabetes self-management education and support. Diabetes care, 36(Supplement 1), S100- S108. http://care.diabetesjournals.org/content/35/11/2393.full A two-page, color PDF document from AADE, “Diabetes Educators: Supporting You, Empowering Your Patients” is available at: https://www.diabeteseducator.org/docs/default-source/legacy- docs/_resources/pdf/general/ProviderBrochure_Downloadable_Final.pdf

    http://care.diabetesjournals.org/content/35/11/2393.full https://www.diabeteseducator.org/docs/default-source/legacy-docs/_resources/pdf/general/ProviderBrochure_Downloadable_Final.pdf https://www.diabeteseducator.org/docs/default-source/legacy-docs/_resources/pdf/general/ProviderBrochure_Downloadable_Final.pdf

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    Community-Based Programs

    Community-based lifestyle intervention programs can be an important part of a health care team. Adding individualized and evidence-based programs like diabetes self-management education (DSME) to a patient’s ongoing care plan can be an effective means of both preventing chronic disease complications and increasing patient agency as part of his/her health care team. These community- based programs want to help their communities, but they need referrals from physicians. They have limited resources for promoting their services, and that’s where primary care providers can help. By reaching out and working with these programs, you can not only help your patients but also improve your ability to effectively manage your patients’ chronic diseases. An empowered, educated and supported patient will more efficiently implement your chronic disease treatment care plan.

    G e t t o k n o w y o u r C o m m u n i t y - B a s e d R e s o u r c e s

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    Joint ADA, AADE and DSME Statement

    Diabetes self-management education and support (DSME/S) is a critical component of diabetes care. Referring patients to an appropriate program may not be as straightforward as it seems. In order to streamline that referral process, the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics have released a joint position statement highlighting the importance of DSME/S as part of routine care and providing an algorithm outlining four critical points in time when it is recommended to assess patients’ need for DSME/S referral, which include:

    1) At diagnosis,

    2) Annually

    3) At the development of complicating factors affecting self-management, and

    4) At a transition of care. In addition to highlighting these junctures, the statement also outlines the educational focus at each of these junctures.

    Press Release http://www.diabetes.org/newsroom/press-releases/2015/joint-statement-outlines- guidance-on-diabetes-self-management-education-support.html? Full Text http://care.diabetesjournals.org/content/38/7/1372.full.pdf+html Prevent Diabetes Stat

    A joint initiative between the American Medical Association and The Centers for Disease Control and Prevention, Prevent Diabetes STAT, aims to inform both health care providers and the public about the importance of preventing type 2 diabetes and raise awareness of the evidence-based Diabetes Prevention Program.

    To learn more about the initiative and download the toolkit, visit: http://www.ama- assn.org/sub/prevent-diabetes-stat/

    http://www.diabetes.org/newsroom/press-releases/2015/joint-statement-outlines-guidance-on-diabetes-self-management-education-support.html?referrer=https://www.google.com/ http://www.diabetes.org/newsroom/press-releases/2015/joint-statement-outlines-guidance-on-diabetes-self-management-education-support.html?referrer=https://www.google.com/ http://care.diabetesjournals.org/content/38/7/1372.full.pdf+html http://www.ama-assn.org/sub/prevent-diabetes-stat/ http://www.ama